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Abstract We investigated the difference in optical coherence tomography angiography characteristics between the patients with compressive optic neuropathy (CON, n = 26) and glaucomatous optic neuropathy (GON, n = 26), who were matched for the severity of visual field defect. The peripapillary retinal nerve fiber layer (pRNFL) thickness in the nasal and temporal sectors was thinner in the CON group, whereas the inferior pRNFL thickness was thinner in the GON group. Accordingly, the CON group had lower peripapillary vessel density (pVD) in the nasal and temporal sectors, and the GON group in the inferior sector. In the macular area, the CON group had a thinner macular ganglion cell-inner plexiform layer in the superior and nasal sectors, whereas the GON group in the inferior sector. However, the CON group did not have a lower macular VD than the GON group in any sector, whereas the GON group exhibited lower superficial capillary plexus VD in the superior, inferior, and temporal sectors. Comparison of the structure–vasculature correlation revealed a significant difference in the nasal and temporal peripapillary areas and superior and nasal macular sectors; a decrease in VD was greater in the GON group than in the CON group when the comparable structural change occurred.

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Abstract We sought to investigate the association between optic nerve head (ONH)/choroidal microvasculature perfusion and optic disc hemorrhage (ODH) in eyes with primary open-angle glaucoma (POAG) using swept-source optical coherence tomography angiography (SS-OCTA). A total of 266 POAG eyes (59 with a single instance of ODH, 40 with a history of recurrent ODH, and 167 eyes without ODH) with a mean follow-up of 5.4 years were included. Intradisc vessel density (VD), parapapillary choroidal VD, optic disc microvascular dropout (MvD), and choroidal microvascular dropout (CMvD), were evaluated on a 3 × 3 mm SS-OCTA image of ONH and compared between eyes with and without ODH. Recurrent ODH was defined as occurrence 1 year after first ODH detection during the total follow-up period. Logistic regression analyses were performed to investigate factors associated with ODH. The prevalence of CMvD, optic disc MvD, and β-parapapillary atrophy were not different among the no ODH, single ODH, and recurrent ODH groups. Eyes with ODH had lower intradisc VDs than those without ODH (P = 0.021), but no difference was found in intradisc VDs between the single and recurrent ODH groups (P = 0.977). Better VF MD at baseline (odds ratio [OR], 1.150; 95% confidence interval [CI], 1.055–1.254; P = 0.002) and lower intradisc VD (OR, 0.863; 95% CI, 0.812–0.918; P

Abstract Background To compare the surgical outcomes and postoperative complications with and without Ologen collagen matrix augmentation during XEN gel stent implantation. Methods We retrospectively analyzed patients who underwent XEN gel stent implantation with an ab externo technique. The amount of intraocular pressure (IOP) reduction, percentage of postoperative complications and additional management, and surgical success defined as IOP reduction greater than 20% compared with the preoperative IOP measurement were compared between Ologen-augmented and non-augmented groups. Groups of patients who underwent XEN gel stent implantation alone and combined with phacoemulsification were analyzed separately. Results A total 103 eyes of 103 participants were included. Of those, 72 eyes underwent standalone XEN gel stent implantation: 42 eyes with Ologen augmentation (Oloxen group) and 30 eyes without Ologen augmentation (Xen group). Thirty-one eyes underwent XEN gel stent implantation with phacoemulsification: 19 eyes with Ologen augmentation (Phaco-Oloxen group) and 12 eyes without Ologen augmentation (PhacoXen group). The surgical success rate at six months postoperatively was not different between the Oloxen and Xen groups (56.4% vs 43.3%, P > 0.05) or between the Phaco-Oloxen group and PhacoXen group (57.9% vs 41.7%, P > 0.05). The prevalence of postoperative hypotony, 5-fluorouracil injections, use of anti-glaucoma medications, bleb needling, and additional glaucoma surgeries was not different between the Oloxen and Xen groups or between the Phaco-Oloxen and PhacoXen groups when assessed six months postoperatively. Conclusions All groups showed significant IOP reduction after XEN gel stent implantation, but there was no significant difference between the Ologen collagen matrix augmented and non-augmented groups in surgical outcomes.

Abstract This study investigated the progression detection capabilities of circumpapillary and macular vessel density (cpVD and mVD) in advanced primary open angle glaucoma (POAG) eyes using the rates of change in VD (trend-based analysis) and variability limits derived from healthy eyes. (event-based analysis) This study included 75 POAG eyes [visual field (VF) mean deviation 0.05) Event-based analysis showed stronger agreement between VD and VF progression (cpVD; kappa value (k) = 0.630, mVD; k = 0.667, P 0.05). In conclusion, VD loss showed better progression detection capabilities than structural loss in advanced POAG eyes. Detection of cpVD and mVD loss may be useful for detecting progression in the advanced stages of POAG to complement other reference standard strategies.

AIM: To evaluate the therapeutic efficacy, safety and tolerability of newly developed preservative-free (PF) latanoprost generic [TJO-002] and compare it with benzalkonium chloride (BAK)-preserved latanoprost [Xalatan®] in patients with primary open angle glaucoma (POAG) and ocular hypertension (OHT). METHODS: Included patients were aged ≥19y with POAG/OHT. After a washout period, patients with IOP 21-35 mm Hg at 9 a.m. were enrolled. After a full ophthalmic and glaucoma examination, 144 patients with POAG and OHT participated in this study. Subjects were randomly assigned either PF latanoprost (74 eyes) or BAK-preserved latanoprost (70 eyes). All subjects were examined at 4, 8, and 12wk after first administration. At each follow-up visit, IOP was measured at 9 a.m. and 5 p.m. and compliance was assessed. Throughout the study, all adverse events were recorded and monitored by the masked investigators who measured IOP. RESULTS: Both groups showed a statistically significant decrease of average diurnal IOP at 12wk compared to baseline (-7.21±3.10 mm Hg in the PF latanoprost group and -7.02±3.17 mm Hg in the BAK latanoprost group, both P

We characterized Müller cell gliosis induced by the activation of transient receptor potential vanilloid-type 4 (TRPV4) and assessed whether statins could modulate the gliosis. The human Müller cell line, MIO-M1, was used to analyze the gliosis caused by glaucomatous stimulation. To induce Müller gliosis in MIO-M1 cells, GSK101 was used to activate TRPV4, and Müller gliosis was evaluated by analyzing vimentin, nestin, and glial fibrillary acidic protein (GFAP) expression. The expression level of TNF-α was determined by ELISA. To evaluate the GSK101 activation of the NF-κB pathway, p65 phosphorylation was measured by Western blotting, and the nuclear translocation of p65 and IκBα phosphorylation were assessed by immunostaining. To assess the effect of statins on MIO-M1 gliosis, cells were pretreated for 24 h with statins before GSK101 treatment. Vimentin, nestin, and GFAP expression were upregulated by GSK101, while statins effectively inhibited them. The expression of TNF-α was increased by GSK101. The phosphorylation and nuclear translocation of p65 and IκBα phosphorylation, which occurs prior to p65 activation, were induced. Statins suppressed the GSK101-mediated phosphorylation of IκBα and p65 translocation. Statins can mitigate gliosis in the human Müller cell line. Because TRPV4 activation in Müller cells reflects glaucoma pathophysiology, statins may have the potential to prevent RGC death.

Purpose. To investigate the effect of refractive error on the physiologic thinning rate of the retinal nerve fiber layer (RNFL) in healthy eyes. Materials and Methods. This study analyzed 223 eyes of 141 healthy subjects followed for more than 5 years and underwent at least five serial spectral domain optical coherence tomography (SD-OCT) examinations. Longitudinal RNFL measurements were analyzed by linear mixed models incorporating follow-up duration, baseline RNFL thickness, spherical equivalent (SE), age, intraocular pressure, and visual field mean deviation. Thinning rates were classified according to SE into three groups: nonmyopic (NM; >0 D), mild-to-moderately myopic (MM; >–6 D and ≤0 D), and highly myopic (HM; ≤–6 D). Results. The overall slopes of change in RNFL thickness over time in the NM, MM, and HM groups were −0.305 ± 0.128, −0.294 ± 0.068, and −0.208 ± 0.097 μm/yr, respectively. Slopes of RNFL thickness changes in these groups were −0.514 ± 0.248, −0.520 ± 0.133, and −0.528 ± 0.188 μm/yr, in the superior quadrant; −0.084 ± 0.145, 0.107 ± 0.082, and −0.161 ± 0.112 μm/yr, in the temporal quadrant; −0.807 ± 0.242, −0.794 ± 0.130, and −0.727 ± 0.183 μm/yr, in the inferior quadrant; and 0.160 ± 0.157, 0.118 ± 0.084, and 0.429 ± 0.119 μm/yr, in the nasal quadrant. Overall and in all four quadrants, there was no significant difference in the rate of RNFL thickness change among the three groups. Conclusions. Refractive error did not affect the physiologic thinning rate of RNFL when assessed by SD OCT.

Glaucoma is an optic neuropathy in which the degeneration of retinal ganglion cells (RGCs) results in irreversible vison loss. Therefore, neuroprotection of RGCs from glaucomatous afflictions is crucial for glaucoma treatment. In this study, we aimed to investigate the beneficial effects of statins in the protection of RGCs using a rat model. Glaucomatous injury was induced in rats by chronic ocular hypertension (OHT) achieved after performing a circumlimbal suture. The rats were given either statins such as simvastatin and atorvastatin or a solvent weekly for 6 weeks. Retina sections underwent hematoxylin and eosin, Brn3a, or cleaved casepase-3 staining to evaluate RGC survival. In addition, modulation of glial activation was assessed. While the retinas without statin treatment exhibited increased RGC death due to chronic OHT, statins promoted the survival of RGCs and reduced apoptosis. Statins also suppressed chronic OHT-mediated glial activation in the retina. Our results demonstrate that statins exert neuroprotective effects in rat retinas exposed to chronic OHT, which may support the prospect of statins being a glaucoma treatment.

Skeletal muscle mass deficiency and quality degradation constitute sarcopenia for elderly people. Sarcopenia can result in musculoskeletal damage and accompany various metabolic problems, which make early sarcopenia diagnosis important. Various modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), have been developed for screening sarcopenia. Recently, ultrasound scanning was suggested for screening sarcopenia because of its safety, usability, and cost effectiveness. However, there has been no standardized assessment methodology for screening sarcopenia with ultrasound scanning. Therefore, prior to this study, we developed a four-degrees-of-freedom (DOF) sarcopenia detection system using an RGB-D camera and an ultrasound probe to automatically scan the human thigh without operator dependency. However, due to the eye-to-hand approach with the RGB-D camera, the system has limited usability for clinical trials. Therefore, in this study we modified the system such that it became eye-in-hand by attaching the RGB-D camera to the upper part of the system with an enhanced arc fitting algorithm. The modified system and enhanced algorithm were verified by an in-vitro test with bean curd-gelatin phantom. The results showed that the thickness of bean curd in the gelatin phantom was maintained at approximately 12.7 ± 0.35 mm over the 71.5∘ scanning range with 2.49 ± 0.15 N radial force at various thickness measuring points.

In this study, we investigated the effect of preservative-free (PF) 0.0015% tafluprost (TA), to the preservative containing (PC) and the PF 0.005% latanoprost (LA) in Korean subjects. This study was conducted as a multi-center, randomized, investigator-blind, active controlled, parallel-group, clinical trial in adult patients (≥19 years) with open-angle glaucoma (OAG) and ocular hypertension (OHT). After a washout period, patients with an IOP between 15 and 35 mmHg were enrolled and evaluated the efficacy, safety, and compliance at 4, 8 and 12 weeks after the first administration. A total of 137 OAG and OHT patients were randomized. Statistically significant reductions in IOP were observed in all groups. Twelve weeks after each eye drop instillation, the mean IOP reduction was −4.59 ± 2.70 mmHg (−24.57 ± 13.49%) in the PC-LA group, −4.52 ± 2.17 mmHg (−24.41 ± 11.38%) in the PF-LA, and −3.14 ± 2.83 mmHg (−17.22 ± 14.57%) in the PF-TA group. The PF-LA showed significantly better responsiveness than did PF-TA. PF-LA was better tolerated than was PC-LA. There were no adverse events that led to cessation of eye drop use in any of the groups. In conclusion, IOP decreased similarly across the groups. PF-LA may provide a good choice for OAG patients with ocular surface diseases.

To investigate the sub-classification of myopic glaucomatous eyes by optic disc and peripapillary features.Optic disc tilt and torsion were determined from retinal nerve fiber layer photographs. Based on the location of the Bruch's membrane (BM) opening within the β-zone of the peripapillary atrophy (PPA) area, the widths of β-zone PPA (PPA1W), PPA+BM (PPA2W), and PPA-BM (PPA3W) were measured with enhanced depth imaging spectral-domain optical coherence tomography. Cluster analysis that employed partitioning around medoids was performed with these parameters, the presence of inward rotation of BM ending axial length (AXL), and central corneal thickness.A total of 115 eyes (AXL≥24 mm) were included. Two clusters produced maximum overall silhouette widths (average = 0.43). Visual field (VF) mean deviation was not different between cluster 1 (52 eyes; -4.02±3.01 dB) and cluster 2 (63 eyes; -5.21±5.62 dB; p = 0.174). In cluster 1 compared to cluster 2, optic disc tilt was significantly greater, PPA1W and PPA3W were longer, and AXL was longer (all p

Purpose. To evaluate the effect of preoperative intravitreal bevacizumab (IVB) injection on the surgical outcome of Ahmed glaucoma valve (AGV) implantation according to the angle status in neovascular glaucoma (NVG) eyes. Materials and Methods. This retrospective study included 70 NVG patients who underwent AGV implantation and were followed up for at least 12 months. An IVB injection before AGV implantation was administered to 45 eyes (IVB group), while it was not administered to 25 eyes (control group). Subgroup analyses were done at different stages in terms of the extent of peripheral anterior synechiae (PAS). Results. Mean follow-up period after AGV implantation was 27 ± 15 months. The IVB group showed higher prevalence of the eyes with less than 50% of PAS than that of the control group (78% versus 44%). The overall success rate 1 year postoperatively was 80% and 64% for the IVB and control groups, respectively (P=0.142). When PAS extent was less than 50%, preoperative IVB had a marginally positive effect on surgical outcome (HR = 0.39, P=0.064, per 1-time IVB injection). Conclusions. Preoperative IVB may enhance the success rate of AGV implantation in NVG eyes, before PAS has extensively formed. Further prospective randomized studies controlling the extent of PAS are warranted.

Pleurotus florida has been widely used for nutritional and medicinal purposes. The present study was conducted to evaluate the antioxidant and anti-inflammatory effects of the fruiting bodies of P. florida extracted with acetone, methanol, and hot water. The antioxidant activities of the acetone and methanol extracts of P. florida showed stronger inhibition of β-carotene-linoleic acid compared to that of the hot water extract. The acetone extract (8 mg/mL) showed a high reducing power of 1.86. The acetone and methanol extracts showed more effective DPPH radical scavenging activities than the hot water extract. The chelating effect of the extracts at lower concentrations was significantly effective compared to that of the positive control. Thirteen phenolic compounds were detected from acetonitrile and hydrochloric acid solvent extracts. Nitric oxide (NO) production and inducible nitric oxide synthase (iNOS) expression in lipolysaccahride (LPS) stimulated RAW 264.7 cells, a murine macrophage cell line, were inhibited significantly by the mushroom extracts in a concentration dependent manner. The anti-inflammatory activity on carrageenan-induced edema in the rat hind-paw reduced significantly by the mushroom extracts. Therefore, we have demonstrated that P. florida fruiting bodies possess antioxidant and anti-inflammatory activites related to their inhibitory activities on NO production, iNOS protein expression, and carrageenan-induced paw edema in rats. The results suggest that the fruiting bodies of P. florida are a good source of natural antioxidant and anti-inflammatory agents.

To investigate the effect of optic disc center displacement on retinal nerve fiber layer (RNFL) measurement determined by spectral domain optical coherence tomography (SD-OCT).The optic disc center was manipulated at 1-pixel intervals in horizontal, vertical, and diagonal directions. According to the manipulated optic disc center location, the RNFL thickness data were resampled: (1) at a 3.46-mm diameter circle; and (2) between a 2.5-mm diameter circle and 5.4-mm square. Error was calculated between the original and resampled RNFL measurements. The tolerable error threshold of the optic disc center displacement was determined by considering test-retest variability of SD-OCT. The unreliable zone was defined as an area with 10% or more variability.The maximum tolerable error thresholds of optic disc center displacement on the RNFL thickness map were distributed from 0.042 to 0.09 mm in 8 directions. The threshold shape was vertically elongated. Clinically important unreliable zones were located: (1) at superior and inferior region in the vertical displacement; (2) at inferotemporal region in the horizontal displacement, and (3) at superotemporal or inferotemporal region in the diagonal displacement. The unreliable zone pattern and threshold limit varied according to the direction of optic disc displacement.Optic disc center displacement had a considerable impact on whole RNFL thickness measurements. Understanding the effect of optic disc center displacement could contribute to reliable RNFL measurements.

Purpose: This study aimed to identify the physical function test differences between the faller group and the nonfaller group in a sample of the community-dwelling elderly. Methods: This study used a nonexperimental two-group-comparative study design. The participants were 356 people aged 65 years and over living in an urban area. From May to December 2010, data were collected through personal interviews using questionnaires and measurements of muscle strength, physical endurance, flexibility, motor agility and dynamic balance, and static balance. The collected data were analyzed by descriptive statistics, Chi square analysis, and t test. Results: Upper muscle strength was significantly weaker in the faller group (p

Lentinus lepideus is an edible mushroom currently available in Korea. The acetone, methanol and hot water extracts were prepared and assayed for their antioxidant and antityrosinase inhibitory activities. The hot water extract showed the strongest β-carotene-linoleic acid inhibition compared to the other extracts. At 8 mg/mL, the methanolic extract showed a high reducing power of 1.21. The acetone and methanol extracts were more effective in scavenging DPPH radicals than the hot water extract. The strongest chelating effect was obtained from the methanolic extract. Xanthine oxidase and tyrosinase inhibitory activities of the acetonic, methanol and hot water extracts increased with increasing concentration. Gallic acid, chlorogenic acid, vanillin, naringin, naringenin, formononetin, and biochanin-A were detected in the acetonitrile and hydrochloric acid (5:1) solvent extract. This study suggests that fruiting bodies of L. lepideus can potentially be used as a readily accessible source of natural antioxidants.

Purpose. To investigate the effect of laser peripheral iridotomy (LPI) in subgroups of primary angle closure based on iris insertion configuration. Methods. Anterior segment optical coherence tomography (AS-OCT) images were obtained before and two weeks after LPI. Qualitative classification of angle closure eyes according to iris insertion (basal insertion group (BG) and nonbasal insertion group (NBG)) was performed. Anterior chamber depth (ACD), lens vault (LV), iris curvature, iris area, iris thickness (IT750), and angle opening distance (AOD750) 750 microns from scleral spur were calculated. Uni- and multivariate regression analysis was carried out to evaluate factors associated with AOD750 before and after LPI. Results. Ninety-two eyes of 92 subjects were categorized as NBG (39 eyes) or BG (53 eyes). The mean change after LPI was not significantly different between two groups in all parameters. In both groups, AOD750 was affected by ACD (p

The goal of accreditation is to ensure that the education provided by an institution of higher education meets an acceptable level of quality. This study developed standards and criteria for accreditation of baccalaureate nursing education programs, by comparing accreditation in South Korea and in the United States, and validating standards and criteria. A main comparative analysis was made between Nursing League for Nursing Accrediting Commission (NLNAC) standards, Commission on Collegiate Nursing Education (CCNE) standards for accreditation of baccalaureate nursing education programs, and Korean Accreditation Board of Nursing standards for accreditation of nursing education programs. The research team developed and validated standards and criteria for South Korean baccalaureate nursing education programs. Using the results of the analysis, revisions are proposed to standards for accreditation of baccalaureate nursing education programs, and categorized into 24 criteria and six domains: mission and governance, curriculum and teaching-learning practices, students, faculty, resources, effectiveness. Further studies are required to refine the standards and criteria and make them sophisticated enough to be applied globally.

In this article, the author demonstrates how a phenomenological approach may be used to describe the changes of women's bodies at menopause. In Korea, the middle age of Korean women has been referred as the golden age and autumn season, and which means Korean thing highly of internal mature rather than external facts. When Korean women experience menopausal, they feel they are in the middle of storm, and just have passed by in the time. They can expert and feel tomorrow's weather by the changes of their body. While the experience menopausal, they can extremely perceive changes of their body, and at the same time, incidence rate of breast cancer is no the increase. Mastectomy has serious effects on both women's body and spirit. Phenomenological analysis on the changes of body shows that the middle age women of Korea feel “Evidently visible scratches of years”, “My body is a live weather forecaster”, “Khi is getting weaker”, “Being fearful suddenly but too late”, “The more aged, the more precious life becomes”, “Being comfortable is better than being beautiful”, “Wish to go back to their past”, “Intense desire for re- challenging life”, “Better friends than husband”. In conclusion, there of no way to fully understand someone without knowing one's lived experience within the cultural context. To understand artificial changes by surgery as well as natural ones, and even to do holistic nursing, qualitative research is essentially required.